Oireachtas Joint and Select Committees

Wednesday, 30 May 2018

Joint Oireachtas Committee on Health

Regulation of Home Care Provision: Discussion

9:00 am

Photo of Louise O'ReillyLouise O'Reilly (Dublin Fingal, Sinn Fein) | Oireachtas source

I welcome the witnesses and apologise for missing the first portion of the meeting but I was unavoidably elsewhere. The waiting list of 1,400 in CHO 9, which is my area, was mentioned. I would be interested in the witness's view as to whether the unacceptably long waiting list in CHO 9 has any relationship to the drop in the number of nurses in the community because since 2007, we have seen a significant drop in the number of nurses in my area. It is a parochial question but it is a broader issue. Is there any relationship between the cut in the number of nursing staff and other staff in the community and the length of the waiting lists for home support?

I would like to make a broader point. There is a registered recognised trade union that represents home helps and home carers but it is not here. An opportunity should be afforded to it, as the registered body, to speak on behalf of those workers. I understand it has written to the committee.

I have a particular view on this matter and, as Mr. Healy alluded to, I had some involvement in representing home helps before I was elected. My view, which is formed from talking to people in my family and in my community, is that the people who are availing of this home care want to be cared for by people who are being treated decently. These people need care and they want to stay in their homes but they want to know that the people who are caring for them are treated with some dignity and respect. When we have representatives of the private sector coming in and saying they want changes to the social welfare rules, that, to me, speaks to a race to the bottom as regards terms and conditions that I do not think is helpful for the development of a service that we all agree needs to be developed.

In respect of the terms and conditions of employment, and Deputy Donnelly asked a question on this, I have a view as to what is enforceable. Maybe Mr. Healy might be able to elaborate a little more as to what is enforceable as regards the contract. There is no joint labour committee, JLC, for home carers, but there is an accepted rate for the job. I would argue that it should be the rate struck by the HSE. My understanding is that is a million miles from the rate that is paid in the private sector. Maybe we could get some information on the difference. In terms of the contract the HSE has for outsourcing work - the two witnesses will be very familiar with my views on this - there is nothing specific in the terms and conditions on it other than that which is set down in legislation. The only obligation on private sector employers who are clearly in this business to make money - that is their responsibility - is to pay the minimum wage. As long as they are doing that, they are fulfilling the terms of that contract. Are there any plans to put some terms and conditions in it that would be helpful to the workers? I have never heard any value-for-money argument advanced that convinced me in terms of directly employed versus privately provided home help services being better value for money. If I am wrong on that and if the value for money argument can be made, I would ask that the witnesses might elaborate on that.

I am interested to know if anyone has undertaken any kind of a survey of the workers, about whom we are talking, and what the results of it are. Ms Metcalfe, as a representative, might outline in what capacity she represents workers. What are the rules of the association? How do people feed into the organisation and how does that representation work? It would be helpful to me, as a former trade union official, to understand that.

On the variation in the provision of service, there is clear variation geographically. Maybe Mr. Fitzgerald is the right man to answer this question but is there any correlation between where carers are directly employed, or are predominantly directly employed, or where the service is predominantly outsourced? Is there any link in terms of this geographic variation? This is a small country, and an even smaller State, so there should be some sort of uniformity of provision. However, there does not appear to any uniformity of provision. We are interested in understanding what the rationale for that is and where that comes from. The witness might be able to provide us with some insight on this.

My final question relates to the time I spent representing these workers. One of the things we were resisting at the time was a reduction in the call-out. It used to be an hour, which was seen as the minimum. Then it went to 30 minutes. As I was exiting that area, there was talk of a 15 minute call-out being introduced. Can all the witnesses advise what is the shortest call-out service that is offered by them and give an explanation? Quite frankly, if it is anything less than an hour, I would like to hear an explanation as to how they think that is actually going to provide a service to an elderly person.

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